Provider Demographics
NPI:1558484311
Name:FERENCE, NANCY ELIZABETH (LCSW-R)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:ELIZABETH
Last Name:FERENCE
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 699
Mailing Address - Street 2:67 WOODLAND WAY
Mailing Address - City:SMALLWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:12778-0699
Mailing Address - Country:US
Mailing Address - Phone:845-583-6147
Mailing Address - Fax:845-583-6147
Practice Address - Street 1:67 WOODLAND WAY
Practice Address - Street 2:
Practice Address - City:SMALLWOOD
Practice Address - State:NY
Practice Address - Zip Code:12778
Practice Address - Country:US
Practice Address - Phone:845-583-6147
Practice Address - Fax:845-583-6147
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR037889-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical